The purpose of the present investigation was to carry out a systematic epidemiological survey on group B Streptococcus, by using the sample materials obtained from the Hospital Laboratory Center of the Teikyo University during two years (1976-1978).The streptococci obtained from these samples were classified according to the serotypes and their susceptibilities to the various antibiotics were examined.
(1) Group B streptococci were found in 97 out of 24, 073 samples.In other words, 97strains were found.Out of these, 56 strains were discovered in the samples from urine (56/8, 039=0.69 %), 17 in those from the pharynx and sputum (17/7, 681=0.22%), 10 in those from stool (10/2, 528=0.40%), 5 in those from pus (5/2, 532=0.21%), 3 in those from secretion (3/1, 288=0.23%) and6in those from others (6/2, 135=0.28%).That the streptococci were more frequently found in the samples from urine than in those from the pharynx and sputum was statistically significant.
(2) Out of97strains, 21were derived from the pediatric sources, the majority being discovered in the samples from the pharynx and stool.There were no significant differences between adults and children as regards the percentage of the discovery of the bacilli in the samples from the given material.
(3) No strains were resistant to penicillin or cephalosporin derivatives.On the other hand, 67 %and19.6%of the total strains were resistant to tetracycline and chloramphenicol, respectively. Only two strains were resistant to macrolides.
(4) Serologically classified, 28.9% of the total strains belonged to type I c and type III while 21.6%to type II.On the other hand, type I a and type I b were infrequently observed.This was statistically significant.
(5) Whereas few of type I a or I b were resistant to the antibiotics tested, many of type III were resistant to tetracycline and chloramphenicol.The majority of type I c or II was resistant to tetracycline only.
(6) The differences between the present results and those of similar studies in the United States were discussed.

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The effects of β-lactam antibiotics on Haemophilus influenzae (H.inf.) were morphologically examined with light and phase-contrast microscopes. Furthermore, the penicillin binding proteins (PBPs) in the inner membrane of H. inf. were isolated and were compared with the PBPs of E. coll.The binding affinity of β-lactam antibiotics to these PBPs was determined by competition with benzyl-[¹⁴C]-penicillin G (¹⁴C-PCG) and the correlation between the affinity and the morphological changes of the bacteria was studied.
(1) When H.inf.was exposed to penicillin G, ampicillin and sulbenicillin, the filament formation was observed at various concentrations lower than MIC and spheroplast was observed at concentrations higher than MIC.With piperacillin or apalcillin, filaments were formed at various concentrations both higher and lower than MIC. Thus the range of the effective concentration for filament formation was larger in these drugs than in the above-mentioned drugs. Of the three cephalosporius tested, the filament formation was observed with cefotiam and cefmetazole at concentrations lower than MIC.The range of the effective concentration was larger in the former than in the latter.
(2) By comparing the PBPs of H.inf. with those of E.coli treated with temperature, it was inferred that the main components of the PBPs of H. inf. were IA, IB, 2, 3, 5 in the order of the molecular weight.The major difference from E.coli was that PBP-IB was found as a single band in a small quantity. On the other hand, PBP-3 made plural bands and no band corresponding to PBP-6 of E.coli was observed in H.inf.
(3) There was no difference in the number of PBPs between the two strains, i.e., one sensitive and the other resistant to ampicillin.In the resistant strain, however, the image showing ¹⁴C-PCG binding to PBP-5 was faint.It was assumed that this is due to hydrolysis of 14C-PCG by, β-lactamase.
(4) The affinity of β-lactam antibiotics to the individual PBPs was measured. It was revealed that sulbenicillin exhibited somewhat stronger affinity to PBP-IB, as compared with other drugs. Little difference, however, was observed between these drugs as regards the affinity to PBP-IB.Cephalosporin showed a stronger affinity to PBP-IA whereas mecillinam exhibited especially a strong affinity to PBP-2.Piperacillin and apalcillin formed filaments at various drug concentrations and exhibited the strongest affinity to PBP-3, followed by cefotiam, penicillin G, ampicillin, sulbenicillin and cefmetazole. On the other hand, cefazolin and mecillinam formed no filaments and showed little affinity to PBP-3. Cefmetazole, which strongly resisted the action of β-lactamase, exhibited a strong affinity to PBP-5.

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In 70 patients (26 males and 44 females) with sick sinus syndrome (SSS) who demonstrated marked sinus bradyarrhythmia, the usefulness of the overdrive suppression test (ODS) was evaluated especially through comparisons between the spontaneous cardiac arrests and those induced by the ODS.
Among the spontaneous cardiac arrests recorded by the long-term ECG, the one which had the longest pause was named the maximum spontaneous cardiac arrest (MSCA).The MSCAs ranged in length from 1.54 sec to 9.00 sec.
Patients were divided into three groups according to the lengths of MSCA and the presence of tachycardiac attacks;29 patients with MSCAs of less than 3.0 sec without any tachycardia were included in group I, 18 patients with MSCAs of 3.0 sec or more without any tachycardia in group ill, 23 patients with bradycardia-tachycardia syndrome in group III.
The ages of all the cases except only one were more than 40 years, with the mean age significantly higher in the order of group I, II and III.
The severest symptoms were seen in group X, and group II had stronger symptoms than group I.And stronger symptoms were seen in females than in males.Furthermore, cases with severe symptoms showed longer MSCAs, and the numerical values of MSCA in group III were higher than those in the other groups.
The longest RR interval among the several beats induced by the ODS was named the maximum induced cardiac arrest (MICA).In 51 of the 70 cases (72.9%), MICAs appeared immediately after the ODS, which proved identical with sinus node recovery time (SRT). When ODS is regarded as positive if SRT exceeds 130% of the PP interval immediately before the ODS, three of the 70 cases were judged as negative.When this criterion was applied to MICA, all the cases were found out to be positive, indicating MICA is more useful in making the diagnosis of SSS.
MICAs ranged in length from 1.79 sec to 8.28 sec, significantly longer in group II and than in group I.
Moreover, they were longer in the cases with stronger symptoms.It was found out as to the nature of the contractions immediately after MSCA and MICA that sinus origin was more frequent than escape in group I and II, while in group X escape after MSCA and sinus after MICA were frequent. There was a significant correlation (r=0.533, p <0.01) between MSCA and MICA.
It is concluded that the MICA provoked by the ODS greatly contributes in making the diagnosis of SSS.

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The occurrence of the breast disease, particularly of carcinoma of the breast tends to be increasing recently in Japan.
The author has attempted to revaluate the diagnostic criteria of the tumorus conditions of the breast in Japanese female in virtue of the thermographic technology and the versatility of this method in an attempt of early detection and effective therapeutic effect is also evaluated.
The results obtained in this investigation are as follows:
(1) One hundred sixty one cases of the breast tissue which included normal, benign and malignant lesions were studied with this technique. The accurate diagnostic percentage of 72.2% was obtained. The accurate diagnostic percentage for normal breast, 83.8%, benign lesion, 51.1% and malignant lesion, 81.6% had been obtained respectively.
(2) The evaluation of the distributing pattern of superficial vascular curve and it property turned out very versatile in differentiating benign and malignant lesions.
(3) Cooling of the lesions with alcohol was applied and the measurement of the superficial temperature of the lesions before and after installation of cooling revealed the fact that this technique also improved the accuracy of the diagnosis.
(4) The attempt to correlate the results of this method and subtyping of the malignant tumors failed to show any significance between them.
(5) The investigative positions to three directions were checked in this study and usage of sitting position should be emphasized as it may represent most stable position for diagnosing morbid lesions.
(6) Base on the above-mentioned observations, the author is to propose a new revised diagnostic criteria of the breast diseases, using this procedure. This may serve as one of the most promising criteria for this purpose.
The clinico-thermographic significance of this method for diagnosing breast disease is fully discussed in this communication.

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Serum samples had been collected from the swine and human beings (mainly slaughterhouse employees) from June 1978 to September 1979. By means of examining the titer of the HI antibody against the A/NJ/8/76 strain of influenza virus in these samples, the behavior of the virus was studied and the following results were obtained.
(1) There was a remarkable regional difference in the prevalence of the A/NJ/8/76 strain among the swine.
(2) It was suggested that among the swine there might be a seasonal variation in the occurrence of the epizootic caused bythe virus.
(3) In about 9 per cent of the slaughterhouse employees examined, the primary infection of the virus was strongly indicated.
(4) No HI antibody against this virus was found in the serum sample collected from the students of the junior high school in an area surveyed in September, 1979.
From these results, it appears that the virus further continues to be epidemic among the swine.Then the behavior of the virus should be kept under surveillance by conducting serological examinations on the slaughterhouse employees.

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In order to study the mechanisms of impaired glucose metabolism in acute myocardial infarction (AMI), fasting blood levels of glucose (FBS), immunoreactive insulin (IRI), free fatty acid (FFA), and growth hormone (HGH) were measured in 59 AMI patients without (A group, 42 cases) and with (B group, 17 cases) a history of diabetes mellitus during 30 days after the attack.These biochemical factors were also obtained by the oral glucose tolerance test (OGTT) performed on 7th, 14th and 30th day in 13 cases of group A and 5 cases of group B, and were compared with those of 20 healthy individuals and 21 diabetic patients without AMI.And, changes of these factors were considered in relation to the severity of the disease.
FBS on 1st day was 184±125 mg/dl which was significantly higher than FBS on 7th (119±45 mg/dl), 14th (102±25 mg/dl) and 30th day (97±15 mg/dl).OGTT of the patients in A group showed diabetic or borderline pattern on 7th day and only 3 patients showed normal pattern thereafter.ΣBS obtained by OGTT were significantly higher in A group than in healthy individuals on 7th, 14th and 30th day, indicating impaired glucose tolerance.
Fasting blood levels of IRI and ΣIRI by OGTT were normal throughout the observation period except high IRI on 7th day, however, insulinogenic index (II) calculated by the formula ΔIRI/ΔBS at 30 minute of OGTT was lower than healthy individuals in each day, indicating the inhibition of insulin secretion.
Fasting blood level of FFA was highest on the 2nd day, then it gradually restored to normal at 14th day.Increase in fasting blood levels of HGH and ΣHGH were observed on 7th day, however, there was no significant correlation between IRI, FFA and BS.
At the time of admission, FBS was significantly higher in non-survivors than in survivors (261±164 mg/dl vs.149±92mg/dl, p<0.01), and positive correlation of r=0.543 (p<0.001) was observed between killips classification of severity and FBS.
It is concluded that inhibition of insulin secretion might be responsible for a mechanisms of observed impaired glucose metabolism which was persisted for 30 days of AMI, and FFA and HGH did not play a role in these events.FBS at the time of admission can be regarded as a valuable prognostic index in AMI.

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Microheterogeneities of rat tissue ferritins were analysed by gel isoelectric focussing and qualitative or quantitative immunoreaction. Ferritins from liver, kidney and heart were purified from 320 male albino rats of Wistar strain. Anti-liver and anti-kidney ferritin antisera were prepared by the immunization of albino rabbits or guinea pigs. The isoferritin profiles detected by the combination of gel isoelectric focussing and protein staining developed clearly 4-5 bands within the range of pI 5.24-5.66 in liver ferritin and pI 5.19-5.47 in kidney and heart ferritins.The change of detection to methods from above iron staining or IRMA (immunoradiometric assay) using anti-liver or anti-kidney ferritin antiserum did not bring any alteration on the profiles. Although some isoferritins located at either acidic or basic end were not always found appreciably in liver or kidney ferritin, both antisera could react to almost all isoferritins from liver, kidney and heart ferritin. In double immunodiffusion these three ferritins formed single precipitation line against both antisera respectively. The end of neighboring two lines was fused together and showed no spur between different tissue ferritins. Meanwhile, the difference in the strength of dose response reaction was observed by the results of 2-site IRMA in different pairs of ferritins and antisera. The relative reactivity of known amount of liver, kidney and heart ferritin against anti-liver and anti-kidney ferritin antisera was 1:1/3:1/4 and 3/2:1:1/4 respectively in the same order. However prior treatment of ferritins with solid state anti-liver ferritin antibody transformed the reactivity against anti-kidney ferritin antiserum to the order of kidney>liver>heart ferritin.The change of the animal for immunization from albino rabbits to guinea pigs did not affect the reactivity of the antiserum.

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Many studies have already been made concerning how the coronary artery branches are distributed into various cardiac parts. The author of the present study has made researches on forty hearts of Japanese fetuses (five to nine months of age), in an attempt to illustrate how the coronary artery branches are distributed at such an early stage of life.
The followings are the summary of the author's observations.
(1) The average angles which both the right and the left coronary arteries make against the median line at the orifices were observed to be: 31.0 degrees on the right and 100.0 degrees the left. Therefore, the average angles formed by the right and the left branches were 131.0 degrees.
(2) As for the patterns of division of the left coronary artery trunk into the anterior interventricular branch and the circumflex branch, those classified as pattern (Crainicianu) I occupied 52.5%, pattern II 32.5%, and pattern III 15.0%.
(3) The interesting relationship of the branch distribution between the anterior interventricular (pattern III 75.0%) and the posterior interventricular (pattern I 82.5%) could be interpreted as indicating that the anterior interventricular branches and the posterior interventricular branches make up for each other to attain full coverage.
(4) As for the patterns of division of the left and right coronary artery branches, those under the category of pattern I-a occupied 42.5%, I-b 25.0%, pattern II-a 30.0%, and pattern III-a 2.5%.

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Disseminated intravascular coagulation (DIC) occurs in various pathological conditions such as malignant tumor, leukemia, shock, and severe infections, particularily in gram negative sepsis. Recently, DIC associated with viral, rickettsial, and mycoplasmal infection has been reported. In this paper, a case of myocarditis complicated with DIC is reported.
A 41 year old female had felt cold accompanied with coughing, fever, palpitation and general malaise since 10 days prior to admission. On admission, a chest X-ray film showed marked cardiac enlargement with pleural effusion in both sides. ECG revealed low voltage, complete left bundle branch block and ST-elevation in I and _aV_L leads. Serum GOT, GPT, CPK, and LDH elevated up to 196, 201, 417, and 2000, respectively. Blood pressure was 88/60mmHg, venous pressure 20mm H₂O. The patient was suspected to have congestive heart failure due to myocarditis, and was given diuretics and digitalis. On the 3rd hospital day, oliguria, marked thrombocytopenia, lowered fibrinogen level as well as an elevation of fibrinogen degradation product developed suddenly, suggesting DIC complication.Despite administration of heparin, her condition did not improve, and died on the 13th hospital day.
An autopsy indicated an evidence of scattered myocardial necrosis with massive hemorrhage, and fibrosis with plasma cell infiltrations in the myocardium. There were an evidence of thrombus formation in the microvasculature of the kidneys and in the sinusoid of the liver, and also severe diffuse bilateral cortical necrosis of the kidneys. DIC was a major factor in the genesis of acute renal failure. In this case, bilateral renal cortical necrosis was thought to be due to DIC, as reported already, and acute renal failure and DIC were considered to be due to myocarditis.

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The anomalies which will be subsequently described were found in the cadaver of a female dwarf whose past and family histories were unknown. The cadaver was one of those to be dissected in 1976 for student education. The weight and the height of the cadaver were 23.0kg and 123.5cm, respectively.
(1) Anomalies in the genital organs.
The vestibulum vaginae was completely closed except for a small cleft of 0, 65cm in length in which there was the ostium urethrae externum just below the clitoris. This finding is compatible with one of the types of “adhesion of the labia minora” classified by Capraro (1972). The median incision of the closed portion exposed all of the vestibulum vaginae. The ostium vaginae was extremely small and only 0.2cm in length. The hymen was thin, double-folded and semilunar in shape. The location and the shape of the clitoris and the bulbus vestibuli were normal, but they were smaller in size. The shape and the size of the uterus and the vagina were extremely anomalous (Photo 4) The tuba uterina was normal, but the ovarium was extremely thin, only O.2 cm in thickness. The histological examination of the adhered portion revealed that the outer surface was covered with the normal cutaneous tissue while the inner surface with the stratified squamous epithelium. Neither in the tela subcutanea nor in the tela submucosa, there was scar tissue. The Gl. uterina and the folliculus ovaricus and secundarius were rarely present.
(2) Anomaly in the site of origin of the A. subclavia dextra.
The arcus aortae was normal. The A. carotis cummunis dextra and sinistra did not form a common trunk, i.e., the so-called truncus bicaroticus. Each arose directly from the arcus aortae, but their sites of origin were close to each other.
The A. subclavia sinistra arose from a site which was 1 cm apart from the site of origin of the A. carotis communis sinistra.
The A. subclavia dextra originated from a site 1 cm below the site of origin of the A. subclavia sinistra, at the level of the third vertebrae thoracicae, and ran behind the trachea and the esophagus toward the upper limb, and gave off the A. vertebralis dextra at the level of the articulatio capitis costae I.
Since the N. laryngeus recurrens dextra did not exist, the N. laryngeus inferior branched off directly from the N. vagus.
It is generally considered possible that in some cases the adhesion of the labia minora is caused by the inflammatory process occurring therein. We are, however, inclined to ascribe the adhesion in the present case to some congenital cause, inasmuch as (1) no scar tissue was found in the adhered portion;(2) there was “Dysgenitalismus”;(3) the cadaver was a dwarf; and (4) there was an anomaly in the site of origin of the A. subclavia dextra.

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